Provider Demographics
NPI:1083877658
Name:FITZGERALD, CARRIE L (DO MPH)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:L
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:DO MPH
Other - Prefix:
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Mailing Address - Street 1:446 JACK MARTIN BLVD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-7733
Mailing Address - Country:US
Mailing Address - Phone:732-840-4300
Mailing Address - Fax:732-840-4515
Practice Address - Street 1:446 JACK MARTIN BLVD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-7733
Practice Address - Country:US
Practice Address - Phone:732-840-4300
Practice Address - Fax:732-840-4515
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101017949208800000X
IA4280208800000X
NJ25MB1124700208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology